Abstract:

Objective: To delineate the clinical features, diagnostic characteristics, and treatment strategies for perianal endometriosis (PEM), aiming to enhance recognition and management of this rare condition. Methods: A retrospective analysis was conducted on seven patients with pathologically confirmed PEM who were admitted to Affiliated Hospital of Jining Medical University from January 2014 to December 2024. Results: All patients had a history of vaginal delivery, of whom four had a history of episiotomy, and three had a history of perineal lacerations. The latency period (interval from the first vaginal delivery to symptom onset) varied widely, ranging from a few months to 19 years. Clinical presentations included perianal masses or pain, with three cases showing symptom exacerbation correlating with the menstrual cycle. Four patients were initially admitted with anorectal disorders such as perianal abscess, mixed hemorrhoids, or anal fistula. All patients underwent resection of the ectopic lesions, and postoperative pathological examination confirmed the diagnosis of PEM. Conclusions: PEM exhibits variable latency and is prone to misdiagnosis. In women with a history of vaginal delivery presenting with perianal masses or pain, PEM should be considered. Detailed obstetric history and imaging examination are crucial for accurate diagnosis, and complete surgical excision is essential for achieving a favorable prognosis.

Key words: Endometriosis, Perineum, Parturition, Retrospective studies, Perianal endometriosis